Toru Shuta, Kanouchi Tadashi, Yokota Takanori, Yagi Yosuke, Machida Akira, Kobayashi Takayoshi
Department of Neurology, Nitobe Memorial Nakano General Hospital, Tokyo, Japan.
Clinical Laboratory, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan.
Eur Neurol. 2018;79(1-2):27-32. doi: 10.1159/000484409. Epub 2017 Nov 13.
We studied autonomic disturbance in patients with dementia with Lewy bodies (DLB), Parkinson disease with dementia (PDD), Alzheimer disease (AD), to determine whether autonomic function tests can be used to distinguish these disorders.
Autonomic function was tested in 56 patients with DLB, 37 patients with PDD, and 59 patients with AD by using the sympathetic skin response, coefficient of variation in R-R interval, the head-up tilt test, serum norepinephrine concentration, and 123I-meta-iodobenzylguanidine cardiac scintigraphy. Symptoms of autonomic dysfunction, such as constipation, urinary symptoms, and orthostatic hypotension, were also noted.
The groups did not differ on baseline characteristics other than those associated with Parkinsonism and dementia. All patients with DLB and PDD had some dysautonomia, whereas rates were much lower for patients with AD (19%). Significantly more DLB and PDD patients than AD patients showed abnormalities on autonomic function tests.
Autonomic function tests might be quite useful to distinguish DLB and PDD from AD.
我们研究了路易体痴呆（DLB）、帕金森病痴呆（PDD）、阿尔茨海默病（AD）患者的自主神经功能障碍，以确定自主神经功能测试是否可用于区分这些疾病。
通过使用交感神经皮肤反应、R-R间期变异系数、头高位倾斜试验、血清去甲肾上腺素浓度和123I-间碘苄胍心脏闪烁显像，对56例DLB患者、37例PDD患者和59例AD患者进行自主神经功能测试。还记录了自主神经功能障碍的症状，如便秘、泌尿系统症状和体位性低血压。
除了与帕金森综合征和痴呆相关的特征外，各组在基线特征上没有差异。所有DLB和PDD患者都有一定程度的自主神经功能障碍，而AD患者的发生率要低得多（19%）。自主神经功能测试显示，DLB和PDD患者出现异常的比例显著高于AD患者。
自主神经功能测试可能对区分DLB和PDD与AD非常有用。
